Preventive healthcare is a luxury that many uninsured people can’t afford. The Centers for Disease Control estimates that about 32% of Texas women over the age of 40 haven’t had a mammogram in the past two years.
In rural areas, resources to provide screenings require a communal effort.
The Access to Breast Health for Texans program was founded in 2024 and has provided roughly 3,000 Bexa breast exams to women in the Big Country and Concho Valley.
Anyone who is 18 or older is eligible to receive a free breast exam. The program is able to offer the exams thanks to a partnership with the Texas Tech University Health Sciences Center.
These exams are a departure from the notoriously uncomfortable mammograms that doctors have relied on for the last six decades.
The Bexa medical device is about the size of a computer mouse and delivers accurate, painless and radiation-free exams.
Tamara Alexander is not only the director of rural initiatives at Texas Tech’s Health Sciences Center, she’s also a breast cancer survivor. She said breast screenings are important because usually, symptoms of breast cancer are unnoticeable in its early stages.
“With my particular case, it was so tiny and so deep into my chest wall, I had no idea, I never felt anything,” Alexander said.
Alexander went to the doctor annually for mammogram screening, which helped her catch her cancer early. She decided to do a radical double mastectomy, followed by a complete hysterectomy three months later.
When breast cancer is caught early, the five-year relative survival rate is over 99%.
Breast cancer that is not caught in its earlier stages can develop into metastatic breast cancer, spreading to other parts of the body, usually bones, lungs or the liver. It is considered to be incurable, with only about a 30% survival rate.
According to the American Cancer Society, there is a 1 in 8 chance that a woman will develop breast cancer at some point in her life, and yet, CDC data also shows that about 1 in 4 women aged 50-74 are not up to date on their mammograms, and women who reported cost as a barrier to access health care have about twice the odds of not getting a mammogram.
“Women have a really hard time putting their health care first because they have jobs, they have husbands, they have children, and they always worry about those items first. And they don’t always take proactive measures for their own health,” Alexander said.
The American Cancer Society recommends that women who don’t have a family history of breast cancer get screening mammograms every year starting at age 40. Women who are 55 and older can switch to getting a mammogram every other year. Women who are at high risk for breast cancer should get a breast MRI and mammogram every year starting at age 30.
But breast cancer targets women of all ages, and when someone outside of the recommendations needs a screening, it may not be covered even if they have insurance.
Pearl Merritt, senior director of outreach at the Laura W. Bush Institute, said that it is becoming more common for women in their 20s and 30s to get breast cancer.
Merritt said that it is critical for younger women to get breast exams because research shows that women diagnosed with breast cancer before the age of 40 face significantly higher mortality rates.
“And so when we do have the exams, there’s several women in their 20s that want to come. Maybe their mother had it and their grandmother had it. They don’t do a mammogram because it’s not going to be paid for at that young age,” Merritt said.
The goal of the Access to Breast Health for Texans program is to break down barriers to screenings, such as age, distance and cost. Every week, the teams set up in a different town in the Big Country and Concho Valley.
Tamara Alexander said teams avoid holding their exams in hospital settings that could be intimidating and turn patients away.
“We try to set up accommodating situations like churches and community centers. We’ve set up an exam room at a boutique before, so anywhere that will host us, we are happy to go in and make that work,” Alexander said.
Instead of a cold hospital room with a large machine that evokes dread in many women, the team creates a setting that is more like a massage experience than a traditional mammogram screening. They prepare a heated massage table in a darkened room lit by a lamp, turn on calming music, and spray essential oils into the room.
Wendy Stolz, a licensed sonographer, explained that the Bexa device uses sound waves to read through breast tissue. She looks for any spots that are stiffer or less elastic than the surrounding tissue.
A detected spot doesn’t necessarily indicate cancer. Stolz said it could be a clogged milk duct, scar tissue, or a cyst. Regardless, if the Bexa device picks up something, the sonographer then does an ultrasound within the same appointment to get more information.
“The only time they don’t get results immediately is if we have to do an ultrasound, because then it has to be read by a radiologist. But still, that turnaround time is 48 hours, so that’s much quicker than even a screening mammo,” Stolz said.
There are pros and cons to both mammograms and Bexa exams. Mammograms pick up microcalcifications, which are tiny calcium deposits in the breast tissue that may develop into cancer, more often than Bexa exams do.
Overall, Alexander said both options are highly accurate and that Bexa is not in competition with mammography at all.
“We always recommend both. But women love Bexa. It’s painless, there’s no radiation, pregnant women can have a Bexa exam, women under 40 can have a Bexa exam, a man can come in and have a Bexa exam. So it touches a lot of populations and age groups that wouldn’t necessarily be going in to get a routine mammogram,” Alexander said.
The program makes scheduling a Bexa exam painless as well. Patients pick a time slot that works for them through a link. There is no wait time, and patients are usually done with the exam in 15 minutes or less.
While the partnership currently covers 24 counties around Abilene and 15 counties around San Angelo, they are working to expand further West. They hope to have a team set up in Midland-Odessa by July.
To sign up for an appointment, visit this link: https://qr.bexaequityalliance.org/abhtalllocations/ or scan the QR code.